Morbidity and Survival after 1,3-6/s(2-chloroethyl)-1-Nitrosourea Wafer Implantation for Recurrent Glioblastoma: A Retrospective Case-matched Cohort Series

Morbidity and Survival after 1,3-6/s(2-chloroethyl)-1-Nitrosourea Wafer Implantation for... AbstractOBJECTIVE:To determine the risks and survival benefit associated with implantation of an absorbable, 1,3-6/s(2- chloroethyl)-1-nitrosourea-impregnated polymer wafer, we prospectively studied patients with recurrent glioblastoma multiforme and compared them with a demographically matched cohort group.METHODS:Over a 29-month period, 62 patients underwent operations. All had tumor growth despite standard treatment, a Karnofsky performance score of >70, and histopathological confirmation of glioblastoma. Seventeen patients underwent gross total resection with placement of 1,3-6/s(2-chloroethyl)-1-nitrosourea wafers (wafer group) at a median 44 weeks from diagnosis (6 women, 11 men; median age, 56 years). A cohort group of 45 patients undergoing surgery for recurrent glioblastoma during the same time period, but not receiving wafers, was identified. Surgery was performed at a median 47 weeks from diagnosis (14 women, 31 men; median age, 54 years).RESULTS:Within 6 weeks of surgery, 13 complications were identified in 8 patients in the wafer group. In the cohort group, 6 patients sustained 8 complications. We were unable to identify any survival advantage using Kaplan- Meier analysis. In the wafer group, median survival was 58 weeks from diagnosis and 14 weeks from wafer implantation. In the cohort group, median survival was 97 weeks from diagnosis and 50 weeks from operationCONCLUSION:1,3-6/s(2-chloroethyl)-1-Nitrosourea wafer implantation for recurrent glioblastoma was associated with a higher risk of postoperative complications, particularly those related to infection and wound healing. No clear survival benefit associated with wafer implantation was identified. http://www.deepdyve.com/assets/images/DeepDyve-Logo-lg.png Neurosurgery Oxford University Press

Morbidity and Survival after 1,3-6/s(2-chloroethyl)-1-Nitrosourea Wafer Implantation for Recurrent Glioblastoma: A Retrospective Case-matched Cohort Series

Morbidity and Survival after 1,3-6/s(2-chloroethyl)-1-Nitrosourea Wafer Implantation for Recurrent Glioblastoma: A Retrospective Case-matched Cohort Series

Morbidity and Survival after 1,3-6/s(2-chloroethyl)-1- Nitrosourea W afer Implantation for Recurrent Glioblastoma: A Retrospective Case-matched Cohort Series Brian R. Subach, M.D., Timothy F. Witham, M.D., Douglas Kondziolka, M.D., L. Dade Lunsford, M.D., Michael Bozik, M.D., David Schiff, M.D. Departments of Neurological Surgery (BRS, TFW , DK, LDL, M B, DS), Radiation Oncology (DK, LDL), and Radiology (LDL), University of Pittsburgh Medical Center, Pittsburgh, Pennsylvania O BJECTIVE: To determine the risks and survival benefit associated with implantation of an absorbable, 1,3-6/s(2- chloroethyl)-1-nitrosourea-impregnated polymer wafer, we prospectively studied patients with recurrent glio­ blastoma multiforme and compared them with a demographically matched cohort group. M ETHODS: O ver a 29-month period, 62 patients underwent operations. All had tumor growth despite standard treatment, a Karnofsky performance score of >70, and histopathological confirmation of glioblastoma. Seventeen patients underwent gross total resection with placement of 1,3-6/s(2-chloroethyl)-1 -nitrosourea wafers (wafer group) at a median 44 weeks from diagnosis (6 women, 11 men; median age, 56 years). A cohort group of 45 patients undergoing surgery for recurrent glioblastoma during the same time period, but not receiving wafers, was identified. Surgery was performed at a median 47 weeks from diagnosis (14 women, 31 men; median age, 54 years). RESULTS: W ithin 6 weeks of surgery, 13 complications were identified in 8 patients in the wafer group. In the cohort group, 6 patients sustained 8 complications. W e were unable to identify any survival advantage using Kaplan- Meier analysis. In the wafer group, median survival was 58 weeks from diagnosis and 14 weeks from wafer implantation. In the cohort group, median survival was 97 weeks from diagnosis and 50 weeks from operation. C O N C LU SIO N : 1,3-6/s(2-chloroethyl)-1-Nitrosourea wafer implantation for recurrent glioblastoma...
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Publisher
Congress of Neurological Surgeons
Copyright
© Published by Oxford University Press.
ISSN
0148-396X
eISSN
1524-4040
D.O.I.
10.1097/00006123-199907000-00004
Publisher site
See Article on Publisher Site

Abstract

AbstractOBJECTIVE:To determine the risks and survival benefit associated with implantation of an absorbable, 1,3-6/s(2- chloroethyl)-1-nitrosourea-impregnated polymer wafer, we prospectively studied patients with recurrent glioblastoma multiforme and compared them with a demographically matched cohort group.METHODS:Over a 29-month period, 62 patients underwent operations. All had tumor growth despite standard treatment, a Karnofsky performance score of >70, and histopathological confirmation of glioblastoma. Seventeen patients underwent gross total resection with placement of 1,3-6/s(2-chloroethyl)-1-nitrosourea wafers (wafer group) at a median 44 weeks from diagnosis (6 women, 11 men; median age, 56 years). A cohort group of 45 patients undergoing surgery for recurrent glioblastoma during the same time period, but not receiving wafers, was identified. Surgery was performed at a median 47 weeks from diagnosis (14 women, 31 men; median age, 54 years).RESULTS:Within 6 weeks of surgery, 13 complications were identified in 8 patients in the wafer group. In the cohort group, 6 patients sustained 8 complications. We were unable to identify any survival advantage using Kaplan- Meier analysis. In the wafer group, median survival was 58 weeks from diagnosis and 14 weeks from wafer implantation. In the cohort group, median survival was 97 weeks from diagnosis and 50 weeks from operationCONCLUSION:1,3-6/s(2-chloroethyl)-1-Nitrosourea wafer implantation for recurrent glioblastoma was associated with a higher risk of postoperative complications, particularly those related to infection and wound healing. No clear survival benefit associated with wafer implantation was identified.

Journal

NeurosurgeryOxford University Press

Published: Jul 1, 1999

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